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Updated: Apr 30, 2026

Author Spotlight: A Novel Setup to Conduct Naturalistic Laboratory Experiments with Real Human Actors in Scenarios

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Case 349.

Matheus Hideki Taborda¹, Matheus Kahakura Franco Pedro^2,3,4, Bernardo Corrêa de Almeida Teixeira^1,5,6

¹Postgraduate Program, Federal University of Paraná, Rua General Carneiro 181, Curitiba, PR, Brazil 80060-900.

|April 28, 2026

Summary

This summary is machine-generated.

A 76-year-old man with neurological symptoms including double vision and dizziness was diagnosed with a rare inflammatory brainstem encephalitis. This condition, characterized by specific MRI findings and cerebrospinal fluid abnormalities, requires prompt diagnosis and management.

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Area of Science:

Neurology
Neuroimmunology
Neuroradiology

Background:

A 76-year-old male presented with a month of worsening binocular diplopia and a week of progressive dysarthria and dizziness.
Patient history included hypertension, dyslipidemia, hypothyroidism, and chronic cervicobrachialgia.
Neurological examination revealed left abducens nerve palsy, right lower facial palsy, horizontal nystagmus, and right lower limb paresis.

Purpose of the Study:

To investigate the cause of the patient's progressive neurological deficits.
To identify potential inflammatory or infectious etiologies.
To characterize the neuroimaging and cerebrospinal fluid findings.

Main Methods:

Brain Magnetic Resonance Imaging (MRI) was performed.
Laboratory blood tests were conducted, including extensive serologic testing for autoimmune markers.
Cerebrospinal fluid (CSF) analysis included opening pressure, cell count, glucose, total protein, and oligoclonal bands.

Main Results:

Brain MRI demonstrated abnormalities in the brainstem.
C-reactive protein was elevated (135 mg/L), while autoimmune serology was negative.
CSF analysis revealed elevated total protein (750 mg/L) and positive oligoclonal bands, with normal cell count and glucose.

Conclusions:

The clinical presentation, MRI findings, and CSF profile are suggestive of an inflammatory brainstem encephalitis.
Despite negative autoimmune markers, the findings warrant consideration of inflammatory demyelinating diseases.
Further investigation and management should focus on this rare neurological condition.